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CF-carrier state associated with more severe cases of bronchiectasis
Journal article   Open access   Peer reviewed

CF-carrier state associated with more severe cases of bronchiectasis

Aaron C Miller, Logan M Harris, Kevin Winthrop, Joseph E Cavanaugh, Mahmoud H Abou Alaiwa, Douglas B Hornick, David A Stoltz and Philip M Polgreen
Open forum infectious diseases, Vol.11(2), ofae024
02/01/2024
DOI: 10.1093/ofid/ofae024
PMCID: PMC10883289
PMID: 38390464
url
https://doi.org/10.1093/ofid/ofae024View
Published (Version of record) Open Access

Abstract

Abstract Background People with CF are at increased risk for bronchiectasis and several reports suggest that CF carriers may also be at higher risk for developing bronchiectasis. The purpose of this paper was to determine if CF carriers are at risk for more severe courses or complications of bronchiectasis. Methods Using Marketscan data (2001-2021), we built a cohort consisting of 105 CF carriers with bronchiectasis and 300083 controls with bronchiectasis but without a CF carrier diagnosis. We evaluated if CF carriers were more likely to be hospitalized for bronchiectasis. In addition, we examined if CF carriers were more likely to be infected with Pseudomonas aeruginosa or non-tuberculous mycobacteria (NTM) or to have filled more antibiotic prescriptions. We considered regression models for both incident and rate outcomes that controlled for age, sex, smoking status, and comorbidities. Results The odds of hospitalization were almost 2.4 times higher (95% CI: 1.116, 5.255) for CF carriers with bronchiectasis compared to non-CF carriers with bronchiectasis. The estimated odds of being diagnosed with a Pseudomonas infection for CF carriers compared to non-carriers was about 4.2 times higher (95% CI 2.417, 7.551) and about 5.4 times higher (95% CI: 3.398, 8.804) for being diagnosed with NTM. The rate of distinct antibiotic fill dates was estimated to be about 2 times higher for carriers compared to controls (95% CI: 1.735 to 2.333), and the rate ratio for the total number of days of antibiotics supplied was estimated to be about 2.8 (95% CI 2.290 to 3.442). Conclusion CF carriers withbronchiectasis required more hospitalizations and more frequent administration of antibiotics compared to non-carriers. Given that CF carriers were also more likely to be diagnosed with Pseudomonas and NTM infections, CF carriers with bronchiectasis may have a phenotype more resembling CF-related bronchiectasis than non-CF bronchiectasis.

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